GOD'S OWN WIDOWS WORLDWIDE, INC.
Non-profit Organization to Care for the Widows and Their Children Worldwide

Widow's Information Sheet

Are you a widow?
Yes No
Are you re-married? If Yes STOP, if No go to step 3
Yes No
What is your full name and address (No P.O. address please)
Full Name
Address
What is your telephone number?
Home
Cell
Work
What is your husband"s full name?
What is your husband"s date of birth?
Month
Date
Year
What was your husband"s date of death?
Month
Date
Year
What was your husband"s cause of death?
How many children do you have?

Please give two(2) References:


(A). From your husband"s family:
Name
Address
Phone
(B). From your own family:
Name
Address
Phone
What are you doing for a living now? If none go to next step.
What would you want to do for a living?
Signature *
Security Code:

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